Confounders in the Interpretation of Paraneoplastic and Neuronal Autoantibody Panels

The recent discovery of several neuronal autoantibodies linked to neurologic syndromes that are fully or partially responsive to immunosuppressive therapy has revolutionized neuroimmunology and expanded the scope of classical paraneoplastic and antibody-related syndromes. A great deal of understanding of the techniques of neuronal antibody testing, the sensitivity and specificity of serum and cerebrospinal fluid sampling, and the value of the specific type and titer of each antibody is imperative. This article provides an overview of neuronal antibody and paraneoplastic panel testing with emphasis on how to differentiate clinically relevant from clinically irrelevant results and the downstream implications of those results.